علاج فرفرية نقص الصفيحات المناعية لدى البالغين عند عدم نجاح علاج الكورتيكوستيرويدات من الدرجة الأولى

References

1. In adults with newly diagnosed ITP, the ASH guideline panel recommends against a prolonged course (>6 weeks) of prednisone in favor of a short course (≤6 weeks) and suggests either prednisone (0.5–2.0 mg/kg/day) or dexamethasone (40 mg/day for 4 days) as the type of corticosteroid for initial therapy.
2. In adults with ITP lasting ≥3 months who are corticosteroid-dependent or have no response to corticosteroids, the ASH guideline panel suggests the following as potential second-line therapies (see Figure 1): thrombopoietin receptor agonist (eltrombopag or romiplostim); rituximab; splenectomy. If possible, splenectomy should be delayed for at least one year after diagnosis because of the potential for spontaneous remission in the first year.